1. The association of black race with receipt of hysterectomy and survival in low-risk endometrial cancer.
- Author
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Taylor KN, Li A, Manuel M, Rimel BJ, and Kim KH
- Subjects
- Female, Humans, Neoplasm Staging, Proportional Hazards Models, United States epidemiology, SEER Program, Black or African American, Endometrial Neoplasms ethnology, Endometrial Neoplasms mortality, Endometrial Neoplasms pathology, Endometrial Neoplasms surgery, Hysterectomy statistics & numerical data, White, Carcinoma, Endometrioid ethnology, Carcinoma, Endometrioid mortality, Carcinoma, Endometrioid pathology, Carcinoma, Endometrioid surgery, Healthcare Disparities ethnology, Healthcare Disparities statistics & numerical data
- Abstract
Objective: To determine whether Black race is associated with treatment and survival among women with low-risk endometrial cancer., Methods: Black and White women with Stage IA grade 1-2 endometrioid endometrial carcinoma diagnosed from 2010 to 2016 in the SEER 18 dataset were identified (n = 23,431), and clinical and socioeconomic attributes obtained. Five-year cancer-specific survival (CSS) and relative survival (RS) were calculated using SEER*Stat 8.3.9. Cox proportional hazards model was used to determine predictors of overall survival (OS) and CSS., Results: There was a significantly higher proportion of Black women who did not have surgery compared to White women (3% vs 1%, respectively; p < 0.0001). Residing in the South, being insured with Medicaid, and residing in a county with low median income were also associated with non-receipt of surgery. Black women remained less likely to undergo hysterectomy on multivariable analysis (OR 0.44, 95% CI 0.32-0.60). Non-receipt of hysterectomy was predictive of decreased CSS (HR 0.14, 95% CI 0.09-0.21) and OS (HR 0.18, 95% 0.14-0.23) on adjusted analysis. Black race was also an independent predictor of increased cancer-specific death (HR 2.07, 95% CI 1.50-2.86) as well as death from any cause (HR 1.74, 95% CI 1.44-2.09) on adjusted analysis., Conclusions: Black women with low-risk endometrial cancer were less likely to undergo hysterectomy and experienced decreased survival relative to White women. Further investigation is warranted to better understand the socioeconomic, geographic, and biologic factors that influence this disparity., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)
- Published
- 2023
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